My Physiotherapy Clinic is Reopening: Is it Safe to Go?

•   May 21, 2020

The past few months have been stressful for Albertans as we have all done our best to stay healthy and keep our family, friends, and neighbors safe from COVID-19. For anyone who has been missing their physiotherapist and physiotherapy treatment, it is welcome news that businesses can begin to re-open and that physiotherapists can now begin to provide services beyond urgent or emergency care.

However, this experience has made us all more aware of the need to protect ourselves and our families from the spread of infections. We may be a little nervous about venturing back out into public spaces and returning to activities that require close personal contact with someone other than our family. Although many of us are excited and ready to get back to our normal routines, some are asking “is it safe to go see my physiotherapist?”

Both Physiotherapy Alberta and the physiotherapists we regulate take your safety seriously. Physiotherapy Alberta has provided direction to physiotherapists regarding the measures that need to be in place for you to receive the care you need in a safe environment.

We keep hearing about the new normal and you probably want to know what that looks like for physiotherapy clinics and other community physiotherapy services. Let us look at what you can expect when you go to see your physiotherapist.

What are physiotherapists doing to keep you safe? 

Physiotherapists, like all regulated health professionals, have a responsibility to provide safe and effective care to the public. They are also expected to comply with all relevant legislation, directives and other guidelines put forth by the Alberta Government and Physiotherapy Alberta. Over the last several weeks, the Chief Medical Officer of Health (CMOH) has provided guidance about the measures to use in health-care settings to help limit the spread of COVID-19, including:

• Ensuring physical distancing in waiting rooms and treatment areas.
• Using appropriate infection control practices including enhanced cleaning and disinfecting.
• Requiring that staff wear medical masks.
• Ensuring clients and staff follow proper hand hygiene practices.
• Keeping detailed records of all individuals who are onsite including staff and clients to facilitate public health tracing of close contacts in the case of a confirmed or suspected positive COVID-19 test result.

Will everyone be able to schedule a clinic appointment immediately?

Although physiotherapists can resume providing in-person care for patients who did not meet previous urgent care criteria, it is important to remember that it will not be business as usual for a while, if ever. In-person services must only proceed when the anticipated benefits of such services outweigh the risks to the patient and the physiotherapist. Physiotherapists must consider many factors as they balance the risks and benefits of providing in-person care to their clients, including the risk that providing in-person care may also increase the spread of the virus.

One of the most effective strategies to protect the patient and the physiotherapist is to avoid unnecessary close personal contact. For this reason, continuing to offer physiotherapy services through telerehabilitation, when appropriate for the patient’s needs, is strongly recommended. Your physiotherapist may recommend that some or all your physiotherapy be provided through telerehabilitation.

Several other factors may affect the ability to schedule in person visits in the coming weeks, including:

• The number of current clients whose care has been delayed or restricted during the peak of the pandemic and who are now seeking to return for treatment.
• Decreased clinic capacity due to space restrictions, physical distancing requirements and staff illness or availability.

Clinic owners and physiotherapists may need to institute a prioritization process to ensure the clients who have the greatest need for in-person care are able to access it in a timely manner.

What should you expect when you arrive for your physiotherapy appointment?

If an in-person visit is appropriate, be prepared for some changes.

1. You may not be able to simply walk in to book an appointment with your physiotherapist. Clinics will probably require all initial contact to be made via phone to determine the need for care and the best way to offer it safely.
2. At the time of booking you should expect to be asked to complete a screening tool such as the COVID-19 Self-Assessment tool available from the Government of Alberta website.
3. You may be asked to wait in your vehicle or outside the clinic until your physiotherapist is ready to see you.
4. You should also expect to be asked to complete the screening tool again, immediately before you enter the clinic or have staff ask you a few more questions when you arrive. This is to ensure that everyone within the clinic is free from symptoms at the time of the visit. The staff you see in the clinic are also expected to undergo screening each day before coming to work.
5. Expect to see fewer staff and patients in the clinic as appointments may be scheduled differently to allow for physical distancing within the space.
6. You will see new signage and posters throughout the clinic reminding people to maintain two-meter physical distance, to employ good hand-hygiene, to cover their coughs and sneezes, and the importance of staying home if you are sick.
7. You should expect to be asked to complete hand hygiene using soap and water or alcohol-based hand rub at the following times:
   • Upon arrival at the practice setting.
   • Before and after use of weights, exercise equipment or similar shared equipment.
   • Prior to processing payment.
   • Prior to departure from the practice.
8. The clinic itself may look quite different. There may be a plexiglass barrier between yourself and the receptionist, there may be limited or no seating available in the waiting room and the treatment rooms or gym area may have been reconfigured to ensure physical distancing is maintained between treatment beds and/or other pieces of equipment.
9. All staff who come in direct contact with you must wear a medical mask at all times.
10. You will also see staff cleaning and disinfecting equipment, tools and common areas frequently.

What about masks? Do I need to wear one?

The CMOH has now indicated that people should use masks when they are in public and in close contact with other people. Wearing a mask protects the people you come in contact with. The CMOH has indicated that medical masks need to be reserved for use by health-care providers, so patients are asked to bring their own masks when coming for treatment.

If a clinic cannot provide medical masks for their staff, the clinic must close until an adequate supply has been obtained. The Alberta government has more information on the use of masks by the public available on its website.

Who do I call if I have concerns that safety measures are not in place? 

If you have concerns, you can call or email the following organizations:

• Physiotherapy Alberta - College + Association. As the regulatory body that oversees the practice of physiotherapy in Alberta, Physiotherapy Alberta’s mandate is to protect the public when receiving physiotherapy services. If you have questions or concerns you can contact Physiotherapy Alberta by phone (780-438-0338) or email (nlittke@physiotherapyalberta.ca).
• You can also submit a complaint or concern to Alberta Health Services’ (AHS) public health inspectors. You can submit a complaint at https://ephisahs.microsoftcrmportals.com/create-case/ or by leaving a message at 310-4455.

Alberta physiotherapists are happy to be able to resume providing you with the care you need in order to be able to work, play, and function at the level you want. However, Physiotherapy Alberta and registered physiotherapists are also committed to providing care in a safe manner and will continue to follow the directives and guidance of the public health experts as clinics reopen across the province.